Claim total
$127.17
base $127.17 · payer covered $77.17
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- diagnosis concept Overdose1149222004
- Start
- 1995-05-24
- Stop
- 1995-05-24
The parties
- Patient
- patient Travis Reichert
- Provider
- provider Ricardo Bartoletti
- Care site
- care site MARTIN LUTHER CARE CENTER
- Payer
- payer Medicaid
Record id
0c81d398-2cb2-843e-8476-c50ca18b0c74